Antiseizure Medications - Divalproex Sodium/Valproic Acid Step Therapy Policy
Cigna step therapy policy requiring use of generic divalproex/valproic acid (Step 1) before coverage of brand Depakote products (Step 2); applies to Cigna-administered health benefit plans.
No material clinical or coverage changes in this revision.
Coverage Criteria
inv-01: Initial Step Therapy
Covered when ALL of the following are met
Step 1 products include generic divalproex sodium capsules, generic divalproex sodium delayed-release tablets, generic divalproex sodium extended-release tablets, generic valproic acid capsules, or generic valproic acid oral solution; Step 2 products include Depakote, Depakote ER/EC/DR, and Depakote Sprinkle.
Divalproex sodium and valproic acid products are covered only when the step therapy requirements in this policy are satisfied. Specifically, Step 1 products (generic divalproex sodium capsules, delayed‑release tablets, extended‑release tablets, generic valproic acid capsules, or oral solution) must be used before a Step 2 product (Depakote formulations) will be approved. If the Step Therapy rule is not met at the point of service, coverage for the Step 2 product will be determined by the step therapy criteria below. Approvals are provided for 1 year.
Any use that does not meet the step therapy requirements described in this policy, including any exception that does not satisfy the Step 1 trial requirement, is considered not medically necessary.
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